Providing Critical Care

Clinical Update 

The last six months have been another extremely busy time for the cDSAA Rapid Response Vehicle and Helicopterrew of Dorset and Somerset Air Ambulance.

In April, we made the transition to providing Pre-Hospital Critical Care for 12 hours a day, seven days a week.  This means that our crew consists of a Critical Care Paramedic (CCP) and Critical Care Doctor, on duty, every single day.

This is important news for the people of Dorset and Somerset, as while we have been providing pre-hospital critical care for a large proportion of our shifts, the public can now expect us to deliver drugs including pre-hospital anesthetics, perform surgical procedures and give organ support to critically ill patients, at the scene of an incident, on any given day.

With the formation of this team comes the capability of providing more inter-hospital transfers and the administration of pre-hospital anesthesia to critically ill or injured patients that need it.  Being able to do the latter, means that our team can also deliver life-saving surgery or other critical care procedures at the scene of an incident before taking the patient to hospital.

Training using manikinsOver the winter period, our team provided a 12 hour service; 10 hours on the aircraft and the latter 2 hours (during darkness) via our Rapid Response Vehicle.  The mode of transport obviously plays a key factor in us being able to reach patients as quickly as possible and our helicopter can cover an extremely large area in a very short time.  However, what’s more important is that when the helicopter is not available, we still have the capability of bringing the Emergency Department to the patient.

We have also been continuing our work with the Helicopter Emergency Medical Service (HEMS) desk and with the South Western Ambulance Service NHS Foundation Trust road crews, to ensure we are mobilised to patients that need us.  In order to make the best use of our Critical Care Team, CCP Paramedic Neil Bizzell has been leading an ‘outreach’ programme to provide knowledge on our capabilities to all involved.

Claire Baker, Neil Bizzell, Phil Hyde, Ian Mew, Paul Owen and Michelle Walker have been providing teaching sessions to a variety of other SWASfT staff, clinicians and students within the paramedic, medical or nursing backgrounds and our whole team is now involved in regional or national teaching of clinical groups.

Working with the CoastguardAll these activities are aimed at educating others of the skills we can provide.  Exposing them to our training, taking part in simulated exercises with other service providers and teaching others the skills we have learnt plays an important part in the appropriate tasking of our aircraft and crew.

Over the last six months our monthly training sessions have covered a range of topics including the management of traumatic cardiac arrest in adults; children and pregnant ladies; blood product resuscitation and head injury management.  Most of these sessions have utilized our infant, child and adult manikins which were purchased by the Charity.

Other simulated training exercises with the Coastguard and Hazardous Area Response Team (HART) have improved interagency co-operation and enabled us to practice real life scenarios and improvements in patient pathways.  In December, our training was based atSimulated exercises the Search and Rescue base in Portland and involved the land based Coastguard Cliff Rescue Team, Search and Rescue and the South Western Ambulance Service NHS Foundation Trust.  These sessions have proved extremely beneficial and the lessons learnt have already been used for treating real patients, demonstrating the importance of this integrated approach.

It’s been an extremely productive and busy start to the year with many more sessions planned for the coming months.  Our thanks go to Owen Hammett for organising and facilitating these activities and to the Wessex Critical Care Programme (www.wessexccp.org), who provide support and technical help on all of the days.Cliff Rescue training

Training does much to keep skills up to scratch, but to keep clinicians up to date with current and developing best practice and the latest research , the team has formed a Dorset and Somerset Air Ambulance Journal Club.  This is led by David Martin and gives our team the opportunity to debate scientific and clinical journal articles and the implications they may have on our service.

So, as you can see, making sure that our patients receive the best possible care requires dedication, commitment and enthusiasm from our whole clinical team; we thank them for being exceptional ambassadors of the Charity.